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WHO Bulletin on Global Fund conflict of interest

An article in the Bulletin of the World Health Organization raises concerns regarding conflict of interest in a partnership where SABMiller, the world’s second largest brewer by sales volume, receive funding from the Global Fund for a HIV/AIDS prevention project in drinking establishements in South Africa. "No conflict of interest" replies the Global Fund.

The recent issue of Bulletin of the World Health Organization carries a round table section: "Global Fund collusion with liquor giant is a clear conflict of interest. The First article is by Richard Matzopoulos, Charles DH Parry, Joanne Corrigall, Jonny Myers, Sue Goldstein and Leslie London. They describe how the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) has recently included SABMiller as a recipient of funding for an education intervention aimed at minimizing alcohol-related harm, including HIV prevention, among men in drinking establishments.The authors think Global Fund support for this initiative is cause for concern.

The article discusses whether men in drinking establishments are the best target group for the intervention, whether a drinking establishment is the best location, and whether the educational intervention itself is effective. Their experience is that the liquor industry is inclined to support alcohol interventions that will not affect drinking rates at a population level. These interventions allow the industry to simultaneously fulfil social and legal obligations to address the harmful use of alcohol while ensuring that sales and profits are maintained.

Providing funding for a highly profitable industry that could afford to fund its own interventions also reduces the funds available for less well-resourced organizations.

Ask the authors: "Do we take it that the problem of “corporate capture” has now spread to one of the largest health funders in the world?"

Global Fund replies
In the Round Table discussion a response from the Global Fund by Victor Bampoe, Amy Clancy, Maya Sugarman, Jon Lidena & Mary Ann Lansanga explains the funding model of the Global Fund and conclude that the Global Fund welcomes andy discussion about the efficacy of interventions and programmes it sopports. However the Global Fund does not recognize any "conflict of interest" in the situation regarding the grant to South Africa.

Expert comments
Anna B Gilmore and Gary Fooksa, two researchers familiar with conflict of interest issues from the tobacco field, say the Global Fund needs to address conflict of interest. They point to the apparent failure by both the Global Fund and the Government of South Africa to recognize and adequately address the potential conflict between corporate interests and public health goals. In this case, because of well-established links between alcohol use, violence (including sexual violence) and risky sexual behaviour, alcohol may be seen as a risk factor in the spread of HIV infection. Reducing alcohol use can therefore be seen as key to reducing HIV infection. Yet this inevitably conflicts with SABMiller’s underlying goal of maximizing profits from alcohol sales.

Gilmore and Fooksa warns that the need for funding will continue to drive corporate philanthropy in global health, until those developing or funding alcohol interventions address these potential conflicts better, problems such as this one under discussion will recur and the harms arising from alcohol misuse will fail to be addressed. Even in the field of tobacco control, which is arguably leading the way in this area, the drive for resources continues to result in conflicts.

They conclude: "It is clear that robust rules for managing potential conflicts of interest are required to ensure effective philanthropy in the public interest."